Organization
ST. MARK'S SOUTH JORDAN FAMILY PRACTICE LLC
Active
Other names
South Jordan Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID J. KANE (VP)
(801) 568-5999
Entity
Organization
Contact information
Practice address
10623 S REDWOOD RD, SUITE 101, SOUTH JORDAN, UT 84095-2481
(801) 302-0899
(801) 302-0892
Mailing address
10623 S REDWOOD RD, SUITE 101, SOUTH JORDAN, UT 84095-2481
(801) 302-0899
(801) 302-0892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982871828
—
UT
Enumeration date
05/09/2008
Last updated
05/20/2010
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